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Text File  |  1993-02-03  |  2KB  |  60 lines
  1.  
  2.  
  3.  
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  5.  
  6.                          Inspire! Registration Form
  7.  
  8.  
  9.         _____________________________________________________________
  10.         Last Name               First Name            Middle Initial
  11.  
  12.         _____________________________________________________________
  13.         Street Address                              Apartment Number
  14.  
  15.         _____________________________________________________________
  16.         City                    State          Zip           Country
  17.  
  18.         ________________________________
  19.         Phone Number (with area code, and country number if outside USA)
  20.  
  21.  
  22.         Applicable Computer Addresses:
  23.         (i.e. internet mail address, Genie/Compuserve address, if any)
  24.  
  25.         _____________________________________________________________
  26.  
  27.  
  28.         Describe Computer Setup:_____________________________________
  29.  
  30.         _____________________________________________________________
  31.  
  32.         _____________________________________________________________
  33.  
  34.  
  35.         Intended usage of Inspire!:__________________________________
  36.  
  37.  
  38.         Where you first heard about Inspire:_________________________
  39.  
  40.  
  41.         Registration Costs $25/unit Delivered:
  42.  
  43.                                 ____ unit(s) * $25 = _____________
  44.  
  45.                                 NE Residents Add   = _____________
  46.                                 6.5% Sales Tax
  47.                                 ($1.63/unit)
  48.  
  49.                                 Total              = _____________
  50.  
  51.  
  52.         Acceptible forms of payment are personal checks, bank checks,
  53.         and travelers checks.  All should be in US Dollars and made out
  54.         to JoshWorks.
  55.  
  56.         Mail this form and your payment to:
  57.                 JoshWorks Software
  58.                 6521 S. 41st Street
  59.                 Lincoln, NE  68516
  60.